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>Journals >Revista de Hematología >Year 2012, Issue 2

González-Ramella Ó, Nájar S, Cuneo-Pareto S, Flores E, Gazarian K, Carrasco YA
Non-Manipulated Autologous Bone Marrow-Derived Mononuclear Cells Implant in Cases of Resistant Chronic Heart Failure
Rev Hematol Mex 2012; 13 (2)

Language: Español
References: 56
Page: 49-57
PDF: 111.75 Kb.

Full text


Background: Transcoronary unselected autologous bone marrow mononculear cells (ABMMC) implant through coronary arteries or veins had shown clinical benefit in patients with acute and chronic heart diseases. Different procedures had been used to assure and improve cell homing and reach ischemic and hypokinetic ventricular areas.
Objective: Herein we show our outcomes using ABMNC in chronic heart failure (CHF)
Material and method: During May 2007 to July 2009, 20 consecutives patients, median age 62 years old (range 34-75), female/male ratio 3/17; 95% of the patients had II to III NYHA class with three patients with IV NYHA class. None of these patient were candidates for myocardial revascularization surgery neither angioplasty. Basal left ventricular ejection fraction (LVEF) was 24,4% (range 12-39). After signed informed consent, a median volume of 564 ml (range 248-950) of bone marrow was obtained from iliac puncture. Leuko-concentrated was performed using HES 6% and refrigerate centrifugation under sterile conditions. Concentrated mononuclear cells were implanted by coronarography of the venous sinus and in selected coronary arteries previous occlusion of the balloon «over wire”. Median number of mononuclear and CD34+ cells infused were 1,6*109 and 2,21*107 respectively.
Results: During and after the procedures no arrhythmias or increase in enzymes or haemodinamic changes were observed. After a median time of 20,1 months, ABMMC led to significant improvement in functional NYHA class. Median ejection fraction improved significantly to 35,1% (p=0.003). Among 18 evaluable patients, 13 (72%) reduced at less one NYHA class and 4 stayed at the same NYHA class, only one patient increase one NYHA class. There was no correlation between cells counts and NYHA or LVEF improvement.
Conclusion: Unselected ABMNC transplantation for CHF is feasible and safe; allows to infuse large volume of cells in quite poor irrigated coronary vessels. This study suggests the potential improvement of symptoms, functional capacity, myocardial perfusion and contractility of ABMNC transplantation in CHF.

Key words: Cellular therapy, cardiac failure, CD34, bone marrow.


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>Journals >Revista de Hematología >Year 2012, Issue 2

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